Drug Abuse and Pregnancy: Some Questions on Public Policy, Clinical Management, and Maternal and Fetal Rights


  • Wendy Chavkin M.D., M.P.H.,

    1. Wendy Chavkin is Perinatal Addiction Research Associate at the Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003.
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  • Machelle Harris Allen M.D.,

    1. Machelle Harris Allen runs a prenatal clinic for chemically dependent women at Bellevue Hospital and is Instructor in the Department of Obstetrics and Gynecology at New York University School of Medicine, 550 First Avenue, New York, NY 10016.
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  • Michelle Oberman J.D., M.P.H.

    1. Michelle Oberman is Director of Research and Assistant Professor of Law at Loyola University School of Law, One East Pearson Street, Chicago, IL 60611.
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ABSTRACT: An estimated 9202 drug-exposed infants were born in the United States in 1986 according to the National Center for Health Statistics; the number increased to 13,765 in 1988. These figures were substantially underreported, however, notes the 1990 report by the U.S. General Accounting Office (GAO) (1). It surveyed 10 hospitals, two each in Boston, Chicago, Los Angeles, New York, and San Antonio, accounting for 44,655 births, of which approximately 4000 resulted in drug-exposed infants in 1989. Maternal cocaine use was estimated to range from below 1 to 12 percent among the 10 hospitals. The GAO report concluded that the number of these infants born nationwide each year could be “very high,” and that in these five cities the unavailability of drug treatment and lack of adequate prenatal care are contributing to the problem (1). Two health professionals and a health lawyer were invited to respond to some questions about the problems of cocaine and substance abuse by pregnant women and how maternity caregivers, health and social service agencies, law, and society are dealing with the issues.